P43 The power of the mind

Introduction Somatoform disorders are a challenge for all branches within medicine but particularly for those working within the paediatric sphere. They are characterized by physical symptoms that are inconsistent with or not fully explained by any underlying medical or surgical diagnosis. In order to reach the diagnosis of a somatoform disorder, children are typically subjected to a number of investigations. Somatoform disorders can have a significant impact within two domains; the economic impact on healthcare resources in reaching a diagnosis and the effect on children in terms of the underlying emotional stress, the practical impact on families, school absenteeism and the treatment of such a condition. For the purposes of this study, we examined the incidence of somatoform disorders within an orthopaedic cohort of patients. Methods This was a retrospective cohort study which examined the incidence of orthopaedic admissions that were attributed to a somatoform disorder over a five year period. All cases which were diagnosed as having a somatoform disorder were included. The individual presentation of each case and the factors of each case that were attributable to the development of such a disorder were assessed in terms of their statistical significance. Factors included childhood trauma, bullying and stressors within the home environment. Further to that, the economic impact of the investigations and treatments initiated prior to a formal diagnosis of a somatoform disorder were assessed in terms of a cost-benefit analysis framework. Conclusions Somatoform disorders are a common theme throughout the varying subspecialties of paediatric medicine in particular orthopaedic surgery which has regular admissions attributable to this disorder. Our research demonstrates that the development of a somatoform disorder is typically attributable to a number of contributing factors. In our study population, some of these factors were found to be statistically significant such as bullying. Further to that, the role of social media was highlighted within several individual cases as a potential factor. This burgeoning influence on children and adolescents highlights the importance of undertaking more research in how this can affect children in terms of their emotional and social development. Finally, in terms of a cost-benefit analysis the economic costs both in the short-term and long-term were illustrated. More investment and development in this area would lead to economic savings in the long-term.